Pandemic Influenza

Potential Impact of an Influenza Pandemic

An influenza pandemic occurs when a novel strain of the influenza virus becomes easily transmissible among people, at which point global spread typically occurs. Three influenza pandemics occurred in the 20th Century (1918, 1957, 1968). In 1918, an estimated 40 to 50 million people died worldwide, 500,000 of them in the United States.

Many experts consider influenza pandemics to be inevitable, although it is not possible to predict when one will next occur. The impact of such an event could have a devastating effect on the health and well being of the American public. In Illinois alone, over the course of 12 weeks:

2 million people may become ill

1.8 million people may require outpatient care

30,000 people may require hospitalization

8,700 people may die

(Source: Extrapolation from national estimates reported by U.S. Centers for Disease Control (CDC). See Fact Sheet: Information about Influenza Pandemics. May 2005.)

Close collaboration between the public health and emergency response sectors will result in Illinois being better prepared for the next pandemic. Many of the current activities related to emergency preparedness (e.g., communication strategies) will prove invaluable during the response to a large magnitude infectious disease emergency.

Five Reasons to Prepare for a Pandemic

An influenza pandemic presents challenges unlike those brought on by other public health emergencies or community disasters:

Simultaneous outbreaks are expected to occur throughout the U.S. and the world, preventing the shifts in human and material resources that typically occur during disasters. The effects of a pandemic on communities will be very lengthy—weeks to months—in comparison with most other disasters.

Vaccines, antiviral agents, antibiotics to treat secondary infections, and medical supplies will be in short supply. Everyone may need two doses of vaccine, one month apart, in order to develop immunity.

Medical facilities will be quickly overwhelmed, possibly requiring the use of non-traditional medical settings and personnel.

Health care workers and other first responders may be at higher risk of exposure and illness than the general population, further impeding the care of victims.

Coordination
The Illinois Department of Public Health has a workgroup charged with identifying and tracking a broad range of preparedness tasks, including medical care surge capacity, epidemiologic analysis, communication, international travel-related risks, and laboratory testing. The Department will make recommendations regarding critical decisions and ensure a coordinated statewide response to the next pandemic.

Agency-Specific Contingency Plans
All state and local agencies should have plans in place to ensure maintenance of essential services during periods of high absenteeism due to illness. Agencies should plan for the worst-case scenario, in which up to 35 percent of the workforce could be absent due to illness or to care for ill family members.

Surveillance
Current influenza surveillance consists of monitoring of influenza-like illness at sentinel surveillance sites around the state and laboratory testing of specimens to confirm, type and subtype influenza virus strains. Additional surveillance activities will be implemented during a pandemic.

Enhanced Surge Capacity in the Health Care System
The adequacy of the existing health-care infrastructure is being examined and contingency plans to address gaps will be developed. Contingency plans to provide food, medical and other essential needs for persons confined to their homes by choice or by direction also will be developed.

Antiviral Medications and VaccineAntivirals: These may be used for prophylaxis and/or treatment of influenza. Shortages are expected. Vaccine: According to CDC, once influenza vaccine is available, Illinois will begin receiving partial allocations on a monthly basis. Priority Groups: In July 2005, the National Vaccine Advisory Committee (NVAC) and the Advisory Committee on Immunization Practices (ACIP) released a set of recommended priorities for the allocation of vaccine and antivirals during a pandemic. Distribution: The federal government will manage allocation of at least the first 100 million doses of vaccine, once it becomes available. Although the exact distribution mechanisms remain undetermined, some combination of hospitals, other health care providers, and local health departments will likely be utilized. Joint planning, training and capability testing by these groups is highly encouraged to establish a robust, coordinated network.

Increase Influenza and Pneumococcal Vaccine Coverage Now
Ensuring annual influenza vaccination of everyone at risk for complications from influenza improves the infrastructure for vaccine delivery and decreases the annual toll of influenza. Ensuring pneumococcal vaccination of everyone at risk for pneumococcal disease will reduce some of the bacterial complications of influenza now and during a pandemic.